When my father died of alcoholic liver disease in 2016, I wanted to understand how this condition happened. As a former nurse, I should have known that he was sick, but the truth is we didn’t. Liver disease can be sneaky, and liver failure, especially from alcoholism, can happen quicker than you think.

However, I know my father’s medications also contributed to his rapidly failing liver because he mixed alcohol with liver-toxic medications. In the hospital, the doctors told us that doing so caused his liver disease to accelerate.

Indeed, according to research, mixing hepatotoxic medications with alcohol is highly dangerous for the liver. However, not all medications are toxic to the liver, but most people don’t realize which ones are toxic and which ones are not. Hepatotoxic drugs are metabolized in the liver and can put a lot of stress on the functions of the liver. Alcohol is also hepatotoxic, which adds even more pressure on the liver.

Medication safety warnings usually point to avoidance of alcohol when taking that specific medication but don’t explain why. Some medicines can make you more dizzy or drowsy when mixed with alcohol, but some warnings are due to the hepatotoxic nature of the medicine. But since these warnings don’t provide details, it’s hard for people to know why the warnings are there.

In writing these educational posts, my goal is to help people understand the information that is not often explained well to the general public. If people have the appropriate education, they can make better choices about their alcohol and medication use.

The following common medications are hepatotoxic, which means they put stress on the liver and shouldn’t be mixed with alcohol.

Acetaminophen

Acetaminophen is metabolized through the liver and can be hard on liver functions. An overdose of acetaminophen, however, can cause liver failure. Taking some Tylenol with alcohol is likely not going to cause liver failure. However, if Tylenol is mixed repeatedly with alcohol over a long period of time, it can contribute to worsening liver issues.

Narcotics

Similar to Tylenol, narcotics are toxic for the liver. Repeated use of narcotics can be hard on the liver, but it becomes a double-whammy when mixed with alcohol. For people who already have liver disease, mixing narcotics and alcohol can rapidly accelerate liver problems. This is what happened to my father — he had chronic pain from diabetes, and he used narcotic medication while drinking a lot of alcohol. Unfortunately, this combo was deadly for him.

Antibiotics and Antifungals

These are common medications that are used for bacterial and fungal infections. These medications can be very hard on the liver and digestive tract. Using alcohol with these medications can make a person quite sick, particularly for antifungal medications. Fortunately, these medications are only used periodically and not long-term.

However, people with alcohol abuse issues are sometimes prone to repeated infections because their immune system has been lowered by heavy alcohol use. This means that antibiotics or antifungals may be used more frequently in this population.

Anticonvulsants

Anticonvulsants are used to treat seizures and epilepsy. However, the medications taken to treat these conditions are hard on the liver. Medications like Valproic acid (anticonvulsant but also used for bipolar disorder and migraines) can sometimes raise liver enzymes even when taken alone. However, when used with alcohol, it can put a lot of stress on the liver and increase the potential for liver damage.

Antipsychotics

Some antipsychotic medications can be difficult for the liver. Medications like chlorpromazine are metabolized through the liver and should not be mixed with alcohol. Other medications include quetiapine, seroquel, and clozapine, to name a few. Unfortunately, many people with mental illnesses like psychotic disorders also struggle with alcohol use disorder. This makes liver issues a high potential for this group of people.

Cholesterol-lowering drugs

Medications like atorvastatin and simvastatin can cause problems with the liver and, as such, shouldn’t be mixed with alcohol. However, 85.6% of US citizens consume alcohol, and 25.8% binge drink. Also, 94 million US adults have high cholesterol and may require the use of medications to lower cholesterol levels.

Diabetes medicine

Insulin and metformin are both used for type 1 and type 2 diabetes. Both these medications can be hard on the liver and therefore shouldn’t be mixed with alcohol. Interestingly, over 34.2 million people have diabetes in the US making it a relatively common condition. As such, many people with diabetes are taking medication to control their blood sugars and possibly mixing these medications with alcohol. Again, this is also what happened to my father. He had type 2 diabetes and also took medication to control his blood sugars. Unfortunately, he mixed several medications with alcohol which caused his liver disease to rapidly worsen.

These are the most commonly used medications that people may mix with alcohol. All of these medications can be toxic to the liver on their own, and when combined with alcohol, can accelerate liver disease. People who take these medications should exercise caution when drinking alcohol.

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Former nurse turned writer — empowering change. Let’s talk about mental health, addictions, trauma, and wellness. Join Medium: https://gillianmay.ca/membership

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Check-ins

Recovery is a lifelong journey, so when times feel unbearable, it’s important to use all of your available resources around you for help. A sober coach is the first point of contact you should lean on after rehab. Sober coaches are there to guide you through the hard times and provide you with advice along the way. Rebuilding relationships with family members should be a top priority as well, especially if the bond was broken in the past. Having a friendly face to rely on and build you up can make all the difference in your sobriety journey. If you’d feel more comfortable having assistance 24/7, try downloading a sobriety app to help stay on track with your progress. The last thing you want is to feel alone.

Start Over

To avoid temptations, distancing yourself from anything or anyone that could have a negative impact on your progress will be in your best interest. Old friends still using, local bars, and even your home can all be temptations. Rebuilding your life somewhere new or close to your family does not have to be dreadful. If money is tight, no need to worry. Consider exploring an FHA loan to assist you in the home buying process. FHA loans are perfect if you’ve experienced a poor financial history, such as debt. It’s government-backed, so it allows you to purchase a home with looser financial requirements. Nonetheless, moving to a new location allows you to start fresh and help avoid any relapses because you’ll be away from things that remind you of your past.

Self-Care

Staying on top of your health is crucial after rehab. Eating healthy, finding a new social group, and starting a new hobby are all ways to guide you through the recovery process. Staying active with a daily routine will also help rid any stress you might be feeling. Just getting outside and going for a walk can be a huge improvement to your mental health. Finding a new friend group that lifts you and supports your sobriety is key to taking care of yourself. If the people around you can’t lift themselves up, how will they be able to help you? Picking up a new hobby to take your mind off things such as reading, journaling, painting, or cooking is also a great way to stay focused. Looking forward to something every day will help you feel grateful and motivated to continue on your sobriety path.

Celebrate

Lastly, don’t forget to celebrate yourself each step of the way. After rehab, everyday life can be challenging. Maintaining your sobriety takes a lot of hard work and dedication. Although big milestones worth celebrating are 30-day, 3-months, 6-months, and 1-year, every day of sobriety is a huge accomplishment. However, one day might be easier than the next, so it’s important to keep your head up during the highs and lows. To help you celebrate your wins, find fun ways to keep yourself motivated such as nice dinners out, dessert, or perhaps starting a new tradition. A tradition could be similar to celebrating a holiday, you could invite friends and family over for a dinner party or book a trip. No matter how you celebrate, always remember you’re not alone and to keep staying motivated — you got this!